Medical and dental exams

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Next time you’re chatting with a bunch of veterans, ask them how their discharge physicals went– and listen to their groans of pain. But seriously, take a few minutes to ask these people what they wish they’d done differently during their physicals. Heed their advice and don’t repeat their oversights!

The basic advice hasn’t changed: start early (at least six months before your terminal leave or retirement date) and be ready to spend several months taking care of other issues before you’re finally finished.

The Department of Defense performs your physical to make sure that you’re healthy and that you receive appropriate medical treatment before you’re discharged. It’s their legal due diligence to prove that they took care of you before you left active duty. Frankly, it’s more for their benefit than yours. You, on the other hand, need to make sure that you understand every aspect of your physical condition and correct as many things as possible during active duty before you have to do it through the Veteran’s Administration or Tricare. It’s the same idea as your other retirement paperwork: get it right the first time or spend months of retirement trying to do it on your own.

When you fill out your physical’s paperwork and start your exams, you or the medical staff may discover new questions or old unresolved issues. Some can be handled immediately but others may require additional time and testing. It’s quite possible to need several months to chase down all the consultations with other doctors, to schedule the complicated examinations like MRIs or CAT scans, and to make a final assessment of the treatment. It’s an unpleasant process, but it’s even more excruciating if you delay.

Prepare yourself before you make your first appointment. Read your entire medical record from start to finish and go all the way back to your entrance exam. Make sure you understand every entry, especially any conditions or injuries or illnesses that may follow you into retirement. If you don’t understand the entries then research the vocabulary on the Internet or ask your shipmates. If you had a medical problem in uniform then you can confidently assume that it could grow to be an even bigger problem in retirement. Make a list of your issues and questions and be ready to spend the time discussing them with technicians, medical staff, and doctors.

When you’re completing the physical’s tests and exams, make sure that you understand everything added to your record. If something doesn’t look right, or if it isn’t thoroughly explained to you, then there’s a problem. An innocuous oversight now may miss an existing condition that could grow worse during your retirement, or it could even result in the denial of a disability claim. Ask to see the instructions or the references to make sure you understand the issues.

It’s quite likely that you’ll leave the exam with a list of consultations, extra appointments, and more testing. Researching the issues and evaluating your treatment options could take a serious chunk out of your final few months. If you start early then you’ll have time to handle the inevitable delays, seek other opinions, and make thoughtful decisions.

Even if all of your questions were answered during the exams and tests, ask your doctor again during the final exam. Bring your list, work it all the way through, take good notes, and don’t get put off or distracted. If your doctor doesn’t seem to have the time for you then ask for another appointment– or another doctor! No one can take more care than you to make sure that your exam is correct, that all issues have been examined, and that you’re in the best possible condition before you retire. I can’t stress strongly enough how important it is to chase down these nagging questions before you complete the physical and retire.

If you’re fortunate enough to be attached to a command with its own independent-duty medical staff, give them an extra-nice favor in exchange for a review of your discharge physical. You might not recognize an incomplete entry or a missing signature, but they’ll know what to look for. This can help avoid errors and delays during your final checkout.

Determining disability ratings and dealing with the Veteran’s Administration are far beyond the scope of this book. If your separation physical discovers a condition that may lead to extensive medical care or even disability concerns, then seek professional help from the medical facility. You may even need to review your rights with your military legal staff. What seems to be a straightforward retirement may become mired in months of medical evaluation boards, disability rating reviews, and maybe even time on the Temporary Disabled Retired List. No one wants this disruption during the planning for the next phase of their life, but you have decades in front of you and the process may be worth tens of thousands of dollars in medical benefits. The person who you’ll become in 30 or 40 years will be heartily glad that you persevered.

It may even be possible that you’ll have to seek help from those who have already gone through the process. Talk to your nearest Veterans Administration office (or the one near your retirement destination) about how they’d like to handle this issue when you’re retired. Seek out a veteran’s organization in your area and see if they have anyone who’s dealt with your problem and can share their wisdom. Contact your local chapter of the Military Officers Association of America for more resources. (Do this even if you’re enlisted– they’ll be glad to help and they’ll know who to contact.) Try the Veterans Benefits Network or the Physical Evaluation Board forum. Post to discussion boards like Military.com or Early-Retirement.org for their advice.

Prescriptions are an aspect of your retirement life that may require considerable thought and planning. Your prescription costs will be considerably cheaper than civilian retirees, but you’ll still need to make sure you can get what you want, in sufficient quantity, when you want it. Consider where you’ll be retired, whether the standard pharmaceutical formulary meets your medication needs, and whether or not you can obtain your medications through Tricare’s mail-order pharmacy. These questions should be asked during your first medical screening, not during the final physical exam.

Discuss the treatment/medication choices with your doctor, and then have a long talk with the pharmacy department. Once you’ve all decided on a long-term medication plan, stock up as much as you can before you retire. You don’t want to run low on your 30-day supply only to find out that there’s been a glitch with transferring your access to the retiree prescription system. Give yourself plenty of time to work through the procedures and, if necessary, to figure out another solution before you run out or have to pay out of your own pocket. This even applies to routine medications such as allergy pills or birth control.

Fully exploit your active-duty or Reserve benefits before you retire. If you’ve been planning to stop smoking or to lose weight or to deal with some other medical/lifestyle aspect, start that project while you’re still on active duty. Depending on your personal/family situation and how much you enjoy planning your life, you may even decide to complete a final pregnancy or vasectomy or tubal ligation with the military healthcare system. If you’re moving from a large military medical system with outstanding care to a remote retirement location with less than excellent facilities, this may be an important decision.

Your retirement physical includes a dental exam. Make the most of it, because retirement dental insurance can be expensive. Consider doing a full set of x-rays, get a good cleaning, and check the condition of any fillings or other dental work. Once you retire you may be fortunate enough to only need an exam every 18-24 months, and it’s frequently cheaper to negotiate a discount with your dentist than to pay for insurance. If you have a history of root canals or gum disease then dental insurance may be a good investment, but i don’t even have any cavities then you may be able to stick to annual or biennial checkups and cleanings.

Whatever you do, don’t avoid seeking treatment. No matter how painful you think it’s going to be, it’ll be even more painful when the doctor or dentist won’t sign your retirement checklist. You don’t want to have to spend your final days of active duty running through the treatment gauntlet with painkillers and physical therapy. Start early and get it done so that there’s time to do it right.

One final word of medical advice. When you’re retired and you’ve settled into your new destination, take a few hours to register at the local Veteran’s Administration office. You may not be eligible for treatment with them, but you may be pleasantly surprised to discover that they’re a Tricare primary care manager. Whether you use their services or not, when you register with them they can add your name to their local roster to ensure that they get their fair share of federal funding for their local military population. Another side benefit of hanging out at the VA is the opportunity to meet all sorts of experienced retirees who know your local area and can help you settle in.

WHAT I DO: I help you reach financial independence. For free. I retired in 2002 after 20 years in the Navy's submarine force. I wrote "The Military Guide to Financial Independence and Retirement" to share the stories of over 50 other financially independent servicemembers, veterans, and families. All of my writing revenue is donated to military-friendly charities.

The book includes the story of a shipmate who was retiring (Yay!). He’d spent most of his Navy career avoiding Navy dentists (Booo…) so when it came time to fill out the retirement checkout sheet he left the dentist’s appointment until the absolute last possible moment. We practically had to drive him over there.

You can see where this is going. They had to do six root canals: one every other week for three months. Not a good way to spend terminal leave…

Nords, I hope that your readers will take this article to heart. Literally. There is NOTHING that I can think that could be more important for future benefits than the discharge physical.

I have been dealing with VA since 1993. I had no idea when I was going through the discharge physical process, of how much it would affect my life. Little things mean a LOT in the future. I cannot tell you how many times I heard “The VA will take care of that when you get out – Don’t worry about that now.” while I was going through the discharge physical process. The thing is… The VA basis their decisions on what is DOCUMENTED from your time in service … meaning no documentation = it did not happen.

Dental may be the most easily overlooked aspect. Not all vets are entitled to VA dental care. Only those with service connection are normally seen by the WAY overloaded VA dental facilities. Even then, the waiting time for treatment can be exhorbant.

I wish you had written this BEFORE I was discharged. I think it is great that you have put this together and I hope that others take the time to read and understand it. What a great tool to have in a toolbox!